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Click here or scroll down to respond to this candidateCandidate's Name
Kissimmee, FL Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEProfessional SummaryProven Medical Billing Specialist with a track record of enhancing the billing operations at Mindful Behavioral Healthcare. Expert in HIPAA compliance and ICD-10 proficiency, significantly improving claim submission accuracy. Demonstrates exceptional communication skills, fostering teamwork and resolving insurance discrepancies efficiently. Achieved prompt payment for services through meticulous insurance verification and patient billing management.SkillsHIPAA ComplianceDenial ManagementICD-10 ProficiencyMedicare and Medicaid processData EntryInsurance BillingMedical claims submissionWork HistoryMedical Billing Specialist 02/2024 to CurrentMindful Behavioral Healthcare Kissimmee, FLCommunicated with insurance providers to resolve denied claims and resubmitted.Posted and adjusted payments from insurance companies.Communicated effectively and extensively with other departments to resolve claims issues.Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.Prepared billing statements for patients and verified correct diagnostic coding.Enrollment Specialist 09/2021 to 12/2023Healthfirst Insurance Lake Mary, FLReview and analyze eligibility and billing reports ensuring members are properly enrolled and premium payments are correctly applied to accounts.Maintain daily production and quality requirements to meet the department service level agreement.Process and perform quality control measures on enrollment and disenrollment transactions and billing activities.Partner with Member Services and other departments to address and resolve member issues within the expected timeframes.Process payments and refunds updating members accounts to reflect changes.Billing Specialist 12/2018 to 08/2021Eye Florida St. Cloud, FLBill carriers by inputting proper ICD 10, CPT codes and billing information into the system initiating electronic transmission.Researched and resolved billing discrepancies to enable accurate billing.Ensured payments are posted properly by verifying the accuracy of coding and charge entry.Increased revenue retention by setting up follow-up system for outstanding payments.Verified patients' eligibility by utilizing appropriate websites and provider portals.Insurance Verification Team Lead/Charge Entry Specialist 08/2015 to 11/2018Florida Eye Clinic Altamonte Springs, FLVerified health insurance policies for all major commercial carriers as well as government healthcare agencies.Completed data entry and reviewed CPT and ICD 10 codes for accuracy prior to submission.Post payments from both insurance and patients ensuring payments are credited to appropriate accounts for accuracy.Oversee that employees were completing verifications of their assigned doctors' schedules in a timely manner.Trained new team members by relaying information on company procedures and safety requirements.Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.Insurance Verification Specialist 09/2014 to 08/2015Surgical Care Affiliates Inc. Orlando, FLResponsible for verifying insurance coverage eligibility, benefits and obtaining authorization and pre certification as required.Calculate deductible and co-insurance estimates for the patient per their insurance contract.Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.Assured timely verification of insurance benefits prior to patient procedures or appointments.Updated patient records with accurate, current insurance policy information.Made contact with insurance carriers to discuss policies and individual patient benefits.EducationBronx Community College - The Bronx, NY |
